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USAID in the Middle East: Famine Early Warning Systems Network (Part 2)

Note: This is the second post in a 4-part series. Read part onepart three and part four.

A map of cultivation areas made by the FEWS NET famine early warning project helps decision makers adapt to and mitigate climate change.

In arid parts of the Middle East and North Africa, famine and climate-related food shortages remain critical development concerns. In sub-Saharan Africa, after devastating famines in the 1980s, USAID created the Famine Early Warning Systems Network – FEWS NET –to monitor and predict developments that affect food security. The system has been serving the region ever since. Among its accomplishments, FEWS NET is known for pioneering the application of satellite remote sensing and models to track and predict climate-sensitive aspects of food security.

There is a powerful interdependence between water availability and agriculture, health, nutrition, and political and economic development. In Yemen, for example, variable rainfall has decreased crop production, food prices are rising, and declining GDP growth and security diminish the population’s ability to obtain adequate nutrition. Today, more than 10 million Yemenis face food insecurity, as do 8 million citizens of Sudan and South Sudan. In Sudan, rainfall has declined by 20 percent since the mid-1970s, with acute impacts for pastoral communities reliant on rainfall for crop production.

Without a stable and sufficient food supply, little other development is possible. Climate change threatens to further destabilize the situation, and recent changes in weather patterns and rainfall have already exacerbated regional water resource management problems. Rain-fed agricultural productivity is particularly vulnerable to shifts in precipitation patterns. Resilience to climate change is critical to ensuring that broad-based development priorities can be met. As Jose Graziano Da Silva, director-general of the U.N. Food and Agriculture Organization, puts it, “there is no food security without water security.”

FEWS NET staff collaborates with U.S. Government agencies, national government ministries and international partners to collect data and produce objective, forward-looking analyses on more than 30 of the world’s most food-insecure countries. FEWS NET helps guide adaptation efforts by providing high quality analyses of recently observed climate trends.

The importance of early warning is critical. With adequate lead time, governments, development agencies and citizens have the opportunity to plan for and mitigate the impact of climate developments. FEWS NET provides continuous monitoring of weather, climate, agricultural production, prices, trade and other factors, and thus can predict and plan for emerging problems. Pioneering in its analytical approach, FEWS NET forecasts the most likely climate patterns up to six months in advance. To help government decision-makers and relief agencies plan for food emergencies, FEWS NET publishes monthly reports on current and projected food insecurity, up-to-the-minute alerts on emerging or likely crises, and specialized reports on weather hazards, crops, market prices and food assistance at www.fews.net.

Programs like FEWS NET are putting to work leading American science and technology in support of effective regional water management and decision-making. “Much of the information that we rely on comes from FEWS NET,” says Abdoulaye Diop, director of the World Food Program in Malawi. “It is quite valuable…no one else on the ground can provide this type of information.”

Read other blog posts in this series:

Improving Tuberculosis Treatment for Children

David Greeley, Senior Vice President at TB Alliance. Photo credit: TB Alliance

World TB Day is Sunday, March 24. 

Fighting tuberculosis (TB) is extremely tough on any patient. Treatment consists of multiple pills each day over the course of at least six months. The medicines often have significant side effects and adhering to treatment often infringes on a patient’s ability to work and interact with his/her family. As prolonged and harsh as it sounds, that is actually the best case scenario for a TB patient. Those who contract or develop TB that is resistant to “first-line” treatments (the most commonly prescribed TB medicines) will be prescribed a still harsher combination of thousands of pills and shots—a draining course of treatment with greater side effects that can last as long as two years. And even then, a clean bill of health is far from guaranteed.

As grueling and debilitating as TB treatment may be for an adult, a child who is infected with TB will face an even rougher road. Treatments for children with TB are the same for children as they are for adults, but the recommended dosages are different. However, pediatric-appropriate versions of TB treatment remain absent from the marketplace. In 2010, WHO issued new guidelines for pediatric TB treatments, however, in the years since, child-friendly TB treatments in the correct dosages have not been produced. Parents or caregivers are left to split or crush adult pills for children, estimating the proper amount of medicine. If they guess wrong, children can be undertreated, resulting in poor outcomes and the development of drug-resistant forms of TB.

Furthermore, because treatments are designed for adults, none of the medicines used to treat children come in formulations that are easy for children to take. This means every dose becomes an adventure for the little ones and their caregivers—a struggle lasting as long as two years in attempt to cure the disease.

As a parent, I find it hard to understand how children with TB can be so neglected. Even among TB patients, who are underserved as a whole, children are particularly vulnerable and face the toughest road to cure when sick. But we’re going to change that! USAID is teaming up with TB Alliance, which is dedicated to the research and development of better TB drugs, to change course, help our children, and brighten the future prospects for the youngest TB patients.

In this new partnership, efforts will promote new understanding of the problem that can help lead to the sustainable supply of new TB drug formulations for children. And a stronger emphasis on patient care will help the world’s youngest TB patients comfortably and confidently survive one of the most persistent diseases ever known.

Greener Pastures in Crimea’s Future

For those of us who have always had it, access to clean water is something that is all too easy to take for granted. We turn on the tap, cook and bathe, and water our lawns and gardens, without ever thinking of the complexities that bring us our clean water.  Others must constantly think about clean water because they have never had access to piped-in clean water in their homes, and have always made do by carrying water from the local well.

In the former Soviet Union, some communities once had access to clean water, but are now suffering the effects of crumbling infrastructure and increasing water demands. Nowhere is this more true than in the small communities scattered across Ukraine’s Crimean Peninsula.

USAID will utilize the existing Soviet-era pump facility (background) in Pervimaysky to irrigate farm fields for a rural community of 300 persons. Photo credit: Jason Gilpin, USAID

Crimea is an attractive region, with a wide variety of ecosystems, rainfall, sunshine, land use and people. For two years as a Peace Corps volunteer, I lived in Sevastopol, a city located on the peninsula’s south-western tip, and often traveled throught small villages and towns in Crimea where Ukrainian NGO colleagues and other volunteers were based. I saw firsthand how many people in rural Crimea go days or even weeks without water, particularly in summer. In many villages, the public water system operates for one or two hours a day only on a few days a week. Even quick showers are a luxury and residents use the brief time the water system is functioning to quickly fill up as many empty plastic containers as possible in order to live through the dry period. Bottled water is expensive for the average Crimean villager, whose monthly income rarely exceeds $200. Crimea is also growing as a tourism destination, further burdening  the overwhelmed public water system during the summer season.

The problem with poor water availability isn’t caused by a lack of water in the region. While Crimea is a fairly dry place, averaging just over 15 inches of precipitation annually, there are ample sources of underground  water and Dnipro river tributary water provided by aqueducts from the north. The challenge is transporting enough water from aquifers and aqueducts to households in order to satisfy seasonal demand during the periods of increased use. This is particularly true in spring and summer when people use this water to irrigate backyard cash crops, which are critical to supplementing rural residents’ annual income.

The USAID Project “Partnership for Sustainable Water Supply for Agriculture Development in Crimea (SWaSAD)” launched in July 2012 by our Ukrainian partner, Agrarian Markets Development Institute, is successfully demonstrating that with transparent planning, modest investment and strong community support, infrastructure improvements can be made that will bring reliable water service to residents in small communities in Crimea. The Project includes demonstration projects in three districts in Crimea: Saki, Pervimaysky and Razdolnensky.

I joined my colleagues from USAID in late February in visiting the communities selected for partnership on this project. In Saki, we heard from the project’s major stakeholders. A local farmer remarked that this project was “very important” in improving crop yields and local income, and that locals were “enthusiastic” about the prospect of reliable water in their communities.

In many ways, the objectives are simple: most of the project sites involve simply connecting the existing water sources, such as the water in a canal with homes along the streets in the villages, using simple irrigation pipes and pumps, so that people can irrigate their backyard cash crops with non-potable canal water without burdening the community’s drinking water system.

One of the project sites plans a broader-based agricultural application on large, communally-owned plots of land. The site we visited in Pervimaysky would restore the function of Soviet-era water infrastructure to irrigate fields farmed by 30 families. This, in turn, would support 300 beneficiaries in the nearby village, providing much-needed employment opportunities and increased economic activity for local businesses. The difference between an irrigated field and a non-irrigated field was fairly obvious and pretty stark — one field a bright green, the other a dull brown.

As tourism continues to develop in Crimea, water demands will continue to grow.  It is economically critical that the region develops a plan to supply reliable potable water to the tourist centers, while also allowing farmers to irrigate their crops, helping to fulfill Ukraine’s promise as the breadbasket of Europe.

What makes this project particularly unique is that USAID/Ukraine is implementing it with the support of the Development Grants Program, which is designed specifically to increase the capacity of locally-managed and operated organizations, thereby increasing local knowledge to sustain the results of USAID-funded initiatives after grant completion. As part of this initiative, our local implementing partner is improving its internal controls and management processes, and developing its human resources so that it can independently achieve results from similar activities.

In the end, we are not only helping Crimea increase its water security and improve the quality of life of local residents, we are also improving the ability of local NGOs to use their own skills and resources to continue to develop this critical region of Ukraine.

The Growing Movement to End Preventable Child Deaths

Yesterday at an event hosted by AEI and the Center for American Progress, USAID Administrator Raj Shah spoke about President Obama’s vision to end extreme poverty through innovation and partnership. His remarks mentioned an important corollary goal – the end of preventable child deaths. The first audience question commended the visionary Child Survival Call to Action held in Washington last year and asked about progress at country-level. Administrator Shah responded that the movement to end preventable child deaths is nothing short of extraordinary.

Administrator Raj Shah earlier this month in India at their Child Survival Summit. Photo Credit: USAID/India

Since the Call to Action, 172 countries have now signed A Promise Renewed pledge to accelerate declines in child deaths.  More than 400 civil society and faith-based organizations as well as over 2,000 individuals have also pledged support. Each signature represents a renewed commitment to give every child the best possible start in life.  Governments are leading the effort to convene policymakers, technical experts, and development partners in a concerted effort to scale-up high-impact strategies for maternal, newborn and child survival. Below are a few highlights of countries leading and how USAID is supporting this important work.
Bangladesh

USAID and other donors are supporting the Ministry of Health to develop an action plan to end preventable child deaths in Bangladesh, particularly at district level.  This plan will identify priority actions and benchmarks to reach the goal of no more than 20 deaths/1,000 live births by 2035, or earlier.  A technical advisory group has been convened to discuss evidence-based interventions that can be deployed in Bangladesh to bend the curve. This includes programs to address Pneumoccocal and Rotavirus vaccines, corticosteroids, clean cord care, child drowning and Kangaroo Mother Care, among others.  Given the fact that 60% of child deaths in Bangladesh occur within in the first 28 days of life, there is a huge need for post-natal monitoring to reduce stubborn neonatal mortality rates.

Burma

Building upon the Child Survival Call to Action, USAID recently launched a public private partnership: Survive and Thrive. This partnership will expand the coverage of quality and high impact maternal newborn services starting with essential newborn care, and link pediatricians, midwives, and obstetricians from American professional associations to peer associations in Burma to build capacity in service delivery. Survive and Thrive will partner with civil society and professional and educational institutions, work within the Ministry of Health’s health system, support the programs of the 3MDG Fund, and maximize synergy with community-based programs of existing partners.

Ethiopia

At the African Leadership on Child Survival meeting hosted by the Government of Ethiopia earlier this year, the consensus reached by over twenty African countries present was both significant and historic. The participating countries declared, in a consensus statement, that they are committed to developing and implementing country-led roadmaps that integrate ongoing efforts to accelerate progress to end preventable deaths among children by 2035, and reduce the mortality rate to below 20 per 1,000 live births in all African nations. Recently, Ethiopia’s Ministry of Health (MOH) signed a Memorandum of Understanding with Namibia. Officials from Namibia are undertaking a study tour to review Ethiopia’s health extension program.

India

At India’s recent Call to Action, the Government of India launched the Reproductive Maternal Neonatal Child Health Adolescent health strategy (RMNCH+A), which serves as a roadmap for the States. India also released several guidance documents including implementation of newborn care as well as management of pneumonia and diarrhea. A National Child Survival Scorecard was showcased, and States were encouraged to develop their own scorecards and to monitor progress. USAID’s Maternal and Child Health Integrated Project (“MCHIP”) supported the Ministry of Health and Family Welfare in organizing the recent India National Call to Action for Child Survival and Development, and USAID will continue to provide support in establishing quick response teams for Indian states with the highest child mortality that have committed to accelerating their efforts for child survival.

Indonesia

USAID supported a national newborn conference in Jakarta from Feb 26-March 1. The conference included international experts from India and the U.S. as well as representatives from the Indonesia’s Ministry of Health, key professional associations, academia, and district and provincial health leaders. This was the first such event in Indonesia focusing on newborn survival. Responding to Indonesia’s commitment to A Promise Renewed and the MOH’s call to accelerate progress toward the MDGs, this conference addresses one of the key indicators slowing achievement of MDG goal 4. DHS data from 2012 is now available and demonstrates no progress in newborn mortality since 2007. The rate remains at 19/1000 live births. Partners are committed to reducing this rate by 25% by 2017, in partnership with USAID, UNICEF and WHO, and an exceptionally strong collaborative relationship with the Ministry of Health.

Liberia

The Ministry of Health in Liberia is sharpening its child survival plan using evidence and aligning donors to support the plan.  There is great donor support and commitment to implementing the national plan through the alignment of programs. A launch for A Promise Renewed is being planned by the Government of Liberia. A steering committee led by the Government of Liberia and comprised of representatives from NGOs, house of representatives, representatives from different Ministries has been established and meets regularly to plan the launch event.  An expected key outcome of the launch is greater mobilization of support and resources at the counties, civil society organizations and community leaders around A Promise Renewed.

For more information about A Promise Renewed, please visit: apromiserenewed.org.

Strengthening the Capacity of Philippine Civil Society Organizations through USAID Forward

Marissa Camacho is the chief of party of the USAID Strengthening the Capacity of Philippine Civil Society Organizations (CSOs) Project. Photo credit: Ayala Foundation

Ayala Foundation became a USAID Forward partner in September 2011 when USAID/Philippines awarded to us the contract to implement the “Strengthening the Capacity of Philippine Civil Society Organizations (CSOs) Project.” The goal of the project is simple: to strengthen the organizational capacity of over a hundred civil society organizations.

The project could not have come at a better time—the Aquino administration is expanding partnerships with civil society in new and exciting areas such as budget transparency, participatory audit, and even election campaign finance monitoring.

Our foundation works with a consortium of leading CSOs and networks in the country — Association of Foundations (AF), Caucus of Development NGO Networks (CODE NGO), Philippine Business for Social Progress (PBSP), Philippine Council for NGO Certification (PCNC), and the National College of Public Administration and Governance (NCPAG) of the University of Philippines. With the support of these organizations, the project helped CSOs to respond to tremendous opportunities for engagement. It also served as a mechanism to pool a wide array of support for their initiatives. Aside from the funding component, USAID also shared its expertise in designing and delivering the training programs that will enhance the capacity of our mentee organizations in managing donor funds, monitoring and evaluation and project design.

In my conversations with participating organizations, they expressed appreciation for the opportunity to seriously assess their organization’s capability and effectiveness. They recognize that “putting their house in order” will increase their potential for partnerships and organizational sustainability. They are willing to invest time and resources to participate in the project because they see this as a meaningful opportunity to advance their development agenda.

I hope to see more donors adopt the USAID Forward model to expand partnerships and to enable local organizations to have a more active stake in the development of the country.

Marissa Camacho is the chief of party of the USAID Strengthening the Capacity of Philippine Civil Society Organizations (CSOs) Project.

Salma Hayek Pinault Presents CHAMPION Project with Award

Actress and Avon Foundation for Women Ambassador, Salma Hayek Pinault, recently presented the USAID-funded CHAMPION project in Tanzania with one of five Avon Communications Awards: Speaking Out about Violence against Women for its outstanding work to bring attention to the need to end violence against women. The CHAMPION Project, implemented by EngenderHealth  with communications support from FHI360, received the award for their work on the Kuwa Mfano wa Kuigwa (Be a Role Model) mass media campaign. The award recognizes outstanding communications campaigns that are helping change communities, policies, institutions, and behaviors to end violence against women.

The CHAMPION Project’s Kuwa Mfano wa Kuigwa campaign is part of a five-year effort to engage men in Tanzania by increasing their involvement in addressing the underlying gender issues and power imbalances in relationships. The campaign, which was launched in Tanzania in collaboration with the Ministry of Community Development, Gender and Children in December 2011, aims to turn men from bystanders to champions with its key message, “Violence is everyone’s problem. Be a role model. Earn respect by standing up to violence.”

Watch a TV spot from the award-winning campaign below and learn more.

 

USAID in the Middle East: Using Data to Improve Regional Water Management (Part 1)

Note: This is the first post in a 4-part series. Read part two,  part three and part four.

Few places are drier than the Middle East and North Africa. Host to 5 percent of the world’s population, the region has only 1 percent of the world’s renewable fresh water. Population growth and increasing demands for food, housing and jobs place extreme pressures on water resources, raising the potential for conflict within and between countries. Climate change could make a challenging situation worse.

The first step for effective water decision-making is data – understanding the location, availability and quality of water resources. To be effective, water management decisions need to be grounded in the best information available. However, political and economic constraints often mean that decisions affecting water use in the region rely upon outdated or inaccurate information.

Making use of NASA satellite data, USAID helps the region’s water managers understand and plan for current and future water needs. This land cover map of northern Tunisia was derived using USAID supported remote sensing and modeling tools. Photo Credit: International Center for Biosaline Agriculture

USAID is working to put accurate data – and the know-how to interpret them – into the hands of the region’s water decision-makers. Since many in the region access shared water resources we are also promoting international cooperation and data sharing toward effective regional water management. Our Middle East Regional Cooperation program (MERC), for example, brings together teams of Arab and Israeli scientists to address common development problems.

This series profiles several initiatives focused on data, technology, cooperation and decision-making. Last year’s World Water Day edition of Global Waters portrayed others.

USAID’s work around the region has helped to improve water and wastewater services available to the region’s citizens, lessen the potential for water-related conflicts, encourage cooperation and increase the region’s ability to adapt to climate change and maintain food security. Water plays a central role in every country’s development. Its availability and quality can hinder or accelerate socio-economic progress. As former Secretary of State Hillary Rodham Clinton noted in her 2012 World Water Day speech, “the water crisis is a health crisis, it’s a farming crisis, it’s an economic crisis, it’s a climate crisis, and increasingly, it is a political crisis.  And therefore, we must have an equally comprehensive response.”

Effective water decisions require accurate data. Using science and technology to improve water decision-making, USAID is helping the region to overcome scarcity, and ensure that water serves as a catalyst for sustainable development.

Regional: In Jordan and Elsewhere

Effective water management requires a regional approach. Water does not necessarily abide by the man-made lines drawn across the sand marking today’s international borders. Rather, it flows – above and below ground – along lines understood by geographers, not those drawn by cartographers. Therefore a transboundary approach, informed by accurate water resources data and decision-making tools, is essential. USAID has taken the lead in making available U.S. satellite data and remote sensing capabilities to key regional water decision-makers.

Joining forces with NASA’s Goddard Space Flight Center, the World Bank, the International Center for Biosaline Agriculture (ICBA), and national agencies in Jordan, Lebanon, Tunisia, Egypt and Morocco, USAID has developed a suite of advanced land surface models to provide regional scale hydrological data relevant to water resource planning and management. Satellite data is verified by local government measurements and fed into analytical models to turn raw data into decision-support tools.

“The overarching goal of these projects is to improve the data available to researchers and decision makers and help foster a culture of data-informed water resources policy and management,” said Mark Peters, USAID’s Regional Water Advisor.  ”USAID is playing an important role in making the most of increasingly scarce regional water resources around the Middle East. Our programs demonstrate the importance of science and technology in water resources decision-making, using data and decision-support tools to make optimal use of water resources and mitigate against water-related conflict.”

For example, in Jordan, one of the most water-scarce countries in the world, USAID is working closely with the Ministry of Water and Irrigation (MWI) to ground-truth NASA satellite data. The detailed satellite information on groundwater levels and vegetative cover are used in conjunction with population statistics and measures of water levels in wells throughout Jordan to enable NASA and USAID scientists to accurately track water levels in aquifers throughout the country. Making use of this resource, USAID and the MWI are able to improve water resource planning efforts, and avoid the over-depletion of key aquifers.

Models indicate that certain aquifers are at risk of over-depletion, and as a result USAID and MWI have redoubled efforts to reduce agricultural water use in these areas. Such findings are reinforced by cooperation between Jordanian scientists and the U.S. Geological Survey evaluating groundwater level and salinity trends around the country. Data produced as a result of this cooperation help prioritize locations for groundwater management, provide a baseline for evaluating impacts of the reduction of over-pumping, and increase public awareness of groundwater trends. “There is severe over extraction of the highlands aquifers,” argues MWI Secretary-General Basem Telfah. “With new information coming from both our well and satellite monitoring systems, it is very clear that Jordanians have to act quickly to change agricultural practices.”

Sound water management begins with good data provision. Groundwater resources are under increasing pressure in the MENA region, and declining levels in many aquifers highlight the need for careful future management. Given the growing and diverse needs for water, decision-makers need to understand current resource limits and the impacts of future policies as they balance competing demands. The United States is a leader in using satellite data and remote sensing technologies to inform water decision-making. We are making available these powerful tools around the arid Middle East as the countries of the region chart their own hydraulic future.

Read other blog posts in this series:

 

How a New USAID Was Born

Dave Eckerson serves as Counselor at USAID

Reflecting on the launch of the USAID Forward Progress Report today, I am reminded of the Mission Director’s Conference held four years ago in Leesburg when we all met Raj Shah for the first time. He had been nominated to be USAID’s administrator, but not confirmed, and his visit to our conference was unofficial—and under the radar of the press. I was mission director in Uganda at the time. And as the nearly 70 of us representing every mission in the world met the man who was about to lead us, the energy was palpable, his questions were many, and we were all impressed.

He had a vision to make USAID the best development agency in the world. He projected an aura of confidence that it could be done. And most important, with respect and humility, he said he couldn’t do it alone. He needed us to tell him how.

Raj left that night, and the next day we threw out the agenda the conference planners had painstakingly developed. Instead, we spent the day developing an agenda for action to present to our new administrator to restore the Agency’s place as the premier development agency in the world.

For all of us, the agenda was grounded in what we learned when we entered the Agency. Be focused and rigorous in what we do and what we don’t do. Develop strategic plans that explain country context, define development objectives, and describe intended results from our assistance. Work directly with host governments and local organizations. Build their capacity to govern and deliver services. Innovate. Use cutting-edge science and technology to enhance our efforts. Be rigorous in our evaluation and monitoring. Share the findings widely to improve what we do, and stop re-inventing wheels that keep falling off wagons. And finally, have enough staff to do the job ourselves, and not rely on hired guns.

I was a member of the group that took our agenda to Raj in his office at the Department of Agriculture the next week. We presented it to him, he asked a lot of questions, and as we left, we all felt he got it.

I returned to Uganda and spent the last three years implementing the agenda that became USAID Forward. We developed the first country development cooperation strategy in the Agency. We focused our resources on clearly defined objectives and results. Reforms in Washington led to major changes in the ways we could do business in the field.

We realized after a rigorous analysis (that we did ourselves) the key focus of our proposed value-chain work in coffee, corn and beans was already being done under a joint European program. Rather than duplicate their work, and pay overhead on a USAID program, we used newly issued procedures to award $20 million to the joint European program. Under the agreement we defined clear measures of performance and accountability. And by doing so, we saved both time and resources.

After two years of implementation, private farmers and farmer organizations are obtaining remarkable yields and services. In a similar vein, DFID recognized the success of our extremely effective reproductive health program and gave us $30 million to extend the program to every district in the country. Again, the USAID Forward reforms radically simplified the way we do business, and allowed us to double the resources we had in an existing grant (without excessive red-tape and bureaucratic delays) to provide family planning services throughout a country with one of the highest population growth rates in the world.

More than anything else, I was awed by the influx of new talent in the Agency under the reform effort. Our U.S. direct hire staff grew by a third during my tenure in Uganda, and the diversity, incredible energy, and talent they brought changed our culture and way of life. We mentored, managed, and watched them grow into remarkably gifted and capable officers. In turn, they taught us the power of mobile technologies. They showed us the reach of their insight, creativity, and new ways of looking at development challenges.

Today the USAID Forward Progress Report tallies up what we have learned and done as an Agency. We have had success. We have had challenges. There is a long way to go to reach our topline indicators.

But, I can assure you one thing. The spirit of USAID Forward is in the hearts and minds of everyone in the Agency. For me, the reforms are in the rearview mirror, and they are leading us to the lane ahead. They are our new reality…and as we take up the president’s call to end extreme poverty in a generation, they will be on the horizon as well.

Take a look at an infographic that illustrates the USAID model of development that puts us on a path to deliver more innovative and sustainable results.

Asking the Right Research Questions to Achieve Global Health Goals

This blog is part of the Global Health Research & Development Blog Series.

Asking the right questions is the first step to generating the ‘downstream’ evidence needed for the implementation of health policies and practices, as my colleague E. Callie Raulfs-Wang described in her March 12 blog. And fostering the right partnerships is crucial to determining the right questions. Partnerships facilitate operations research, or the testing of scalable solutions that overcome barriers to access, demand, and quality in real world settings. Investing in operations research to accelerate results is also a key strategy in the Global Roadmap of the Child Survival Call to Action. This pledge, signed by more than 160 governments, renewed their commitment to child survival and to eliminating all preventable child mortality in two decades, as USAID Administrator Rajiv Shah explained.

A thriving Ethiopian child. Photo credit: Nazo Kureshy

USAID’s Child Survival and Health Grants Program (CSHGP) supports new operations research partnerships among non-governmental organizations (NGOs), academia, and ministries of health to generate evidence about how to solve critical challenges in the implementation and scale-up of high impact maternal, newborn, and child health interventions. By working in partnership with ministries of health, studies are designed to meet the ministries’ expressed needs for evidence that would strengthen their systems. Solutions are tailored to local contexts, with relevance to global implementation challenges, such as how best to: integrate services within and across sectors; improve the continuum of care to maximize access and lower costs; ensure equity in access to health information and appropriate use of services; and strengthen systems’ capacity for accountability to communities.

As USAID’s Jim Shelton commented in Nature magazine this year, promoting health literacy for preventive health behaviors such as handwashing and breastfeeding, and deploying community-based interventions for services and health education, are among the priority public health approaches needed now for universal access to health.

Some questions that must be addressed in order to operationalize these approaches include:

  • How can community health workers (CHWs) more effectively reach households with timely information, case management, and referral?
  • What are effective models for partnerships between health care providers and community agents/traditional caregivers to improve the continuum of care and increase demand for services through culturally appropriate and respectful care?
  • How can data collected by communities be used as a communication and planning tool to improve the quality of care and accountability?

The answers to these questions would facilitate the research goals of integrated maternal and newborn health, child health, and nutrition, as outlined in USAID’s Report to Congress: Health-Related Research and Development Strategy. As stated in the research goals for health systems strengthening (HSS), “Ensuring equitable access to high-quality essential health services requires an increase in the evidence base on how to best implement HSS interventions and promote uptake of best practices.” These partnerships have the potential to achieve more than the sum of their parts by bringing together perspectives and skills that yield rigorous, relevant, and practical evidence.

At this year’s Global Maternal Health Conference in Arusha, Tanzania, presenters from CSHGP’s NGO partners in Peru, Liberia, Pakistan and Ecuador shared experiences on bridging the gap between communities and health systems to meet the maternal and newborn health needs of their most vulnerable populations . These research projects are helping ministries of health learn how best to operationalize and improve current policies on providing culturally competent, respectful care, and are testing new systems for overcoming geographic and financial barriers to safe childbirth. These partnerships are meeting the evidence needs of ministries of health that are striving to implement policies that make access to care more equitable.

To learn more about some of these 30 research partnerships in 23 countries check out this brief (PDF).

Read other posts in the Global Health Research & Development Blog Series:

Follow USAID Global Health on Facebook and Twitter (@USAIDGH).

 

USAID Answers President’s Call to End Extreme Poverty

Rajiv Shah serves as Administrator at USAID.

Earlier this year, in the State of the Union address, President Obama called upon us to join the world in ending extreme poverty in the next two decades. It was an extraordinary moment, as the President set forth a vision for one of the greatest contributions to human progress in history.

The truth is that many people don’t realize that this goal is within our reach. I often find myself battling the perception that politics today cannot support great moral aspirations or that government cannot usher in innovative, cost-effective ways of achieving those goals.

But in my last three years as Administrator, I’ve seen just the opposite. From a church in inner-city Detroit that looks after an orphanage in Ghana to the nationwide response after the Haiti earthquake, I’ve seen the depth of passion and support that Americans have for our work. And at a time of seemingly uncompromising politics, I’ve seen leaders from both sides of the aisle stand together as champions for this global task.

Today, I am pleased to share with you our third annual letter about the work our Agency does around the world to help answer President Obama’s call.

From the Afghanistan to Ethiopia, we are building on this support and a foundation of reform to pioneer a new model of development that engages talent and innovation everywhere to achieve extraordinary goals. So for this year’s letter, we’ve gathered a few examples that focus on the capacity of partnerships to maximize our impact and scale meaningful results. From partnering with small community banks in the Philippines to local imams in northern Nigeria to multinational agriculture companies in Tanzania, we are trying to change the way development works to achieve extraordinary goals.

We’re excited about our progress, but we also know we have far to go to make this model a defining part of the way we work. I am eager to hear your thoughts and reactions, and I look forward to working with you to advance our mission and realize the end of extreme poverty.

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